Systemic lupus erythematosus and chronic kidney disease under dialysis treatment: A case presentation
DOI:
https://doi.org/10.55204/trc.v6i2.e716Keywords:
Systemic lupus erythematosus, lupus nephritis, chronic kidney disease, hemodialysis, hyperkalemiaAbstract
Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune pathology characterized by the production of autoantibodies that lead to severe organ damage, with lupus nephritis being the main responsible for the progression to terminal Chronic Kidney Disease (CKD). The objective of this study is to analyze the process of comprehensive clinical care and stabilization in a 24-year-old male patient with SLE and stage 5 CKD on triweekly hemodialysis, who was admitted to the emergency department of the Manabita hospital with severe metabolic decompensation. The methodology used corresponds to a descriptive and qualitative clinical case study, structured under the Nursing Care Process (PAE) using the NANDA-I, NOC and NIC taxonomies. The results showed an anuric patient with critical hyperkalemia (potassium 6.5 mEq/L), secondary arterial hypertension, fluid overload (edema ++), fever and an active infectious/inflammatory focus (CRP 87.91 mg/L). The prioritized emergency interventions included the administration of 10% calcium gluconate, nebulizations with salbutamol, antibiotic therapy adjusted to renal function and immediate preparation for rescue hemodialysis. After the execution of the care plan, electrocardiography stabilization, the decrease of serum potassium to safe values (<5.5 mEq/L) and the gradual remission of fluid overload and febrile condition were achieved. It is concluded that the systematized application of the ECP in the emergency area is decisive in reducing morbidity and mortality, avoiding lethal arrhythmias and restoring homeostatic balance in patients with complex autoimmune and renal involvement.Downloads
References
1. Fanouriakis A, Kostopoulou M, Andersen J, Aringer M, Arnaud L, Bae SC, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2023;83(1):15-29. doi:10.1136/ard-2023-224762
2. Rovin BH, Adler SG, Barratt J, Bridoux F, Burdge KA, Chan TM, et al. Executive summary of the KDIGO 2021 Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4):753-79. doi:10.1016/j.kint.2021.05.015
3. Zhu J, Zhu Q, Li X, Shen T, Shi X, Zhao T. Systemic lupus erythematosus and male reproductive health: A systematic review and meta-analysis. Autoimmun Rev. 2025;24(4):103742. doi:10.1016/j.autrev.2025.103742
4. Poveda VDB, Alves JDS, Santos EDF, Moreira AGE. Diagnósticos de Enfermería en Pacientes Sometidos a Hemodiálisis. Enfermería Global. 2024;13(2):58-69. doi:10.6018/eglobal.13.2.167841
5. Elena M, Rivadeneira R, Isabel S, Rochina C, Elizabeth M, Chalán E. Complicaciones y factores asociados a la mortalidad en pacientes con enfermedad renal crónica en tratamiento dialítico. Rev Ecuat Enf Salud. 2021;15(2):45-58.
6. Minh Tuan Pham, Anh Tuan Hoang, Anh Tuan Le, Al-Tawaha AR, Dong VH. Clinical profiles of chronic kidney disease stage 5 under hemodialysis. J Med Res. 2024;2:306-12.
7. Silver R, Craigo S, Porter F, Osmundson SS, Kuller JA, Norton ME. Society for Maternal-Fetal Medicine Consult Series #64: Systemic lupus erythematosus in pregnancy. Am J Obstet Gynecol. 2023;228(3):B41-60. doi:10.1016/j.ajog.2022.09.001
8. González-García A, Cusácovich I, Ruiz-Irastorza G. Treatment of systemic lupus erythematosus: new therapeutic options. Rev Clin Esp (Engl Ed). 2023;223(10):629-39. doi:10.1016/j.rceng.2023.11.001
9. Parikh SV, Almaani S, Brodsky S, Rovin BH. Update on Lupus Nephritis: Core Curriculum 2020. Am J Kidney Dis. 2020;76(2):265-81. doi:10.1053/j.ajkd.2019.10.017
10. Webster AC, Nagler EV, Morton RL, Masson P. Chronic Kidney Disease. The Lancet. 2017;389(10075):1238-52. doi:10.1016/S0140-6736(16)32064-5
11. Ketteler M, Block GA, Evenepoel P, Fukagawa M, Herzog CA, McCann L, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update. Kidney Int. 2017;92(1):26-36. doi:10.1016/j.kint.2017.04.006
12. Bhandari S, Spencer S, Oliveira B, Mikhail A, Brooks O, Bryant G, et al. UK kidney association clinical practice guideline: update of anaemia of chronic kidney disease. BMC Nephrol. 2025;26(1):1-37. doi:10.1186/s12882-025-04115-1
13. Palmer BF, Carrero JJ, Clegg DJ, Colbert GB, Emmett M, Fishbane S, et al. Clinical Management of Hyperkalemia. Mayo Clin Proc. 2021;96(3):744-62. doi:10.1016/j.mayocp.2020.06.014
14. Dörner T, Furie R. Novel paradigms in systemic lupus erythematosus. The Lancet. 2019;393(10188):2344-58. doi:10.1016/S0140-6736(19)30546-X
15. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181-247. doi:10.1007/s00134-021-06506-y
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